# CITY OF CRAWFORD

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Ponderosa Villa
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902860190
- **Authorized official:** MRS. SANDRA J PERKINS (ADMINISTRATOR)
- **Authorized official phone:** (308) 665-1224

## Contact information

- **Practice address:** 1ST & PADDOCK, CRAWFORD, NE 69339
- **Practice address phone:** (308) 665-1224
- **Practice address fax:** (308) 665-2450
- **Mailing address:** PO BOX 526, 1ST & PADDOCK, CRAWFORD, NE 69339
- **Mailing address phone:** (308) 665-1224
- **Mailing address fax:** (308) 665-2450

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 214002 | NE | — |
| 314000000X | Skilled Nursing Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 04/14/2006
- **Last updated:** 07/31/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 060034 | BLUE CROSS BLUE SHIELD | NE |